Comparison of the mitral valve morphologies of Cavalier King Charles Spaniels and dogs of other breeds using 3D transthoracic echocardiography

Abstract

BackgroundMyxomatous mitral valve disease (MMVD) is more prevalent in Cavalier King Charles Spaniels (CKCSs) compared to dogs of other breeds at a given age. Abnormal valvular stress is thought to contribute to the development and progression of MMVD, and a relationship exists between mitral valve (MV) morphology and stress acting on the valve.ObjectivesTo determine whether the MV morphology of healthy adult CKCSs differs from the morphology of healthy adult dogs of other breeds determined by RT‐3DTTE.AnimalsThirty‐five healthy CKCSs and 41 healthy dogs of other breeds.MethodsProspective cross‐sectional study. Dogs underwent physical examination, conventional echocardiography, and RT‐3DTTE. RT–3DTTE datasets were analyzed using dedicated software for MV morphologic analysis. Morphologic variables were compared between CKCSs and dogs of other breeds.ResultsThe MV of healthy CKCSs had a smaller annulus height (0.46 ± 0.11 vs. 0.56 ± 0.17; P = .0021), tenting height (0.26 ± 0.12 vs. 0.42 ± 0.18; P < .001), tenting area (0.42 ± 0.15 vs. 0.79 ± 0.34; P < .001), normalized tenting volume (0.09 [0.05–0.13] vs. 0.14 [0.10–0.20]; P < .001), and normalized area of the posterior leaflet (0.57 ± 0.15 vs. 0.66 ± 0.18; P = .016) compared to healthy dogs of other breeds; this results in CKCSs having a flatter MV with reduced tenting, compared to the MV of other breeds.Conclusions and Clinical ImportanceThese morphologic features could confer a mechanical disadvantage and play a role in the predisposition of CKCSs to the early development of MMVD.

Echocardiographic Evaluation of the Mitral Valve in Cavalier King Charles Spaniels

“…As reported by Menciotti et al (2018) [ 16 ], a 3D transthoracic echocardiography of the mitral valve of healthy young adult CKCS showed that leaflet tenting and the posterior leaflet were reduced in comparison with dogs of other breeds. These morphologic differences could predispose this breed to the early onset of MMVD [ 16 ]. The identification, at a young age, of dogs at high risk of adverse outcomes in the future is desirable [ 17 ].…”

Joint virtual issue on recent advances in veterinary cardiac imaging

“…Many articles focused on the most common heart disease of dogs—myxomatous mitral valve degeneration—highlighting the prognostic value of mitral regurgitation severity as well as improved methods to quantitate both the regurgitant orifice and degree of cardiac remodeling . Advanced analysis of the geometry of the mitral valve by 3‐dimensional (3D) echocardiography also expands our understanding of the disease phenotype . Although advanced 3D echocardiography is limited primarily to research centers, point‐of‐care ultrasound was demonstrated to be a useful screening tool to overcome the challenges of detecting heart disease in cats by nonspecialists practitioners .…”

“…11 Advanced analysis of the geometry of the mitral valve by 3-dimensional (3D) echocardiography also expands our understanding of the disease phenotype. 12 Although advanced 3D echocardiography is limited primarily to research centers, point-of-care ultrasound was demonstrated to be a useful screening tool to overcome the challenges of detecting heart disease in cats by nonspecialists practitioners. 13 The last 5 years also demonstrate an increased focus on the right ventricle, [14][15][16] the side of the heart that has been largely ignored in the past.…”

Joint virtual issue on recent advances in veterinary cardiac imaging

“…Many articles focused on the most common heart disease of dogs – myxomatous mitral valve degeneration – highlighting the prognostic value of mitral regurgitation severity as well as improved methods to quantitate both the regurgitant orifice and degree of cardiac remodeling . Advanced analysis of the geometry of the mitral valve by three‐dimensional echocardiography also expands our understanding of the disease phenotype . While advanced three‐dimensional echocardiography is limited primarily to research centers, point‐of‐care ultrasound was demonstrated to be a useful screening tool to overcome the challenges of detecting heart disease in cats by non‐specialists practitioners .…”

“…phy also expands our understanding of the disease phenotype. 12 While advanced three-dimensional echocardiography is limited primarily to research centers, point-of-care ultrasound was demonstrated to be a useful screening tool to overcome the challenges of detecting heart disease in cats by non-specialists practitioners. 13 The past 5 years also demonstrate an increased focus on the right ventricle, [14][15][16] the side of the heart that has been largely ignored in the past.…”